Importance of counselling ICD patients: The role of cardiac physiologists

Abstract

Implantable Cardiac Defibrillators (ICDs) have proven mortality benefits in those at risk of cardiac arrest due to Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT). ICDs present challenges not only in the technical management of the device but also on the psychosocial impact it has on a patient. ICD counselling prior to implantation and in some instances during follow up, can allow a patient to address the concerns they may have and attempt to minimise any possible negative psychosocial impact. ICD counselling should be provided by appropriately experienced healthcare professionals, in some UK centres this service is provided by cardiac physiologists and specialist arrhythmia nurses. The chapter specifically focuses on the role of a cardiac physiologist which is reflective of practise within our centre (St Georges' Hospital, London, UK). ICD counselling prior to implantation is a way of protecting a patients' autonomy and allows informed consent by empowering the patient with appropriate detail as well as giving them the opportunity to discuss the positive and negative aspects of the device. ICD counselling presents many different patient related challenges. This chapter aim is to explore these and offer advice on how to overcome them based on experiences within our centre.